[Correlation between transthoracic and transesophageal echocardiography and surgery in mitral stenosis].

This prospective study was designed to analyse transthoracic and transesophageal echocardiographic findings in the morphological study of the mitral valve and to compare them with surgical findings. This study was based on a series of 60 consecutive patients (38 men and 22 women with a mean age of 36.3 +/- 4.2 years) undergoing open heart surgery for pure or very predominant symptomatic mitral stenosis between November 1993 and December 1994. All patients were investigated by transthoracic and transesophageal echocardiography an average of 3 days before the surgical operation. Qualitative analysis of the mitral valve was rigorously performed according to a 4-point severity score taking into account mobility, thickness and degree of valve calcification as well as the condition of the subvalvular apparatus. The global echocardiographic score corresponded to the sum of the scores for these 4 elements. Transesophageal echocardiographic data and surgical findings were identical: global score: 9.3 vs 9.5, mobility: 2.8 vs 2.9, thickness: 2.6 vs 2.5, calcifications: 1.7 vs 1.8, condition of the subvalvular apparatus: 2.2 vs 2.3. The degree of valve damage was overestimated by transthoracic echocardiography compared to surgical data: global score: 10.4 vs 9.5 (p < 0.05), mobility: 3.1 vs 2.9 (p < 0.05), thickness: 2.8 vs 2.5 (p < 0.01), calcifications: 2.1 vs 1.8 (p < 0.01), but the difference was not significant for the condition of the subvalvular apparatus: 2.4 vs 2.3. In conclusion, surgical findings in pure or very predominant mitral stenosis are more closely correlated with transesophageal echocardiographic data than with transthoracic echocardiography, which tends to overestimate the severity of anatomical lesions, particularly valvular calcification.